Microneedling: monotherapy or adjuvant treatment?

Skin care and skin health has risen to ever-increasing prominence in public opinion within recent years. A patient's satisfaction with the appearance of their skin should be even more pressing to the aesthetic practitioner when considering the fact that dermatological conditions, such as acne vulgaris, can significantly impair a person's psychosocial wellbeing, relationships and quality of life. Indeed, as an example, 25.7% of 723 cross-sectional survey participants with atrophic acne scars felt less attractive or were embarrassed or self-conscious because of their scars; furthermore, 8.3% reported being regularly verbally and/or physically abused because of their scars, and 43.2% felt that their scars had negatively impacted their relationships (Tan et al, 2021).

Microneedling, a process involving repetitive puncturing of the skin with sterilised microneedles, presents a minimally invasive modality that is fast gaining popularity, due to its ability to harness the potential of the body's own regenerative processes and its versatility for both at-home and professional use. It is most commonly used as a skin resurfacing and rejuvenation procedure, with the microwounds caused by the tiny needles of the microneedling device triggering collagen production through a downstream wound healing cascade. However, there is debate as to whether microneedling is more effective as either an adjuvant treatment or as a monotherapy for a growing number of applications. To prepare for an increasing variety of patient concerns, aesthetic professionals must be appraised of the benefits of microneedling as either a mono- or combination therapy for a range of different applications.